The principles of asepsis are those procedures or rules applied to the prevention of infection, to ensure that a certain object or space is sterile and free of microorganisms. Asepsis refers to the absence of microorganisms or infection.
The word asepsis comes from the Greek, where the prefix "a" means "without", "sepsis" means "putrefaction" and the suffix "ia" indicates quality. Therefore, it is the quality of an object to remain free from putrefaction or decomposition.
The term asepsis should not be confused with the term antisepsis, which although they go hand in hand, the latter refers to the process of disinfection of an organism previously infected with live pathogenic microorganisms.
The main objective of asepsis is to reduce the risk of disease transmission in hospitals, especially in the surgical area.
Provides all health care users with all the necessary objects and materials, in optimal conditions for use.
How did asepsis arise?
From the seventeenth to the nineteenth century, deaths from systemic infections after injuries, surgical interventions or in the immediate postpartum period were very numerous.
The pattern of communication between the inside and outside of the human body began to be noticed, with the onset of fevers that usually culminated in the death of the patient.
Joseph Clarke in 1790, discovered the relationship of puerperal deaths with the poor hygiene of the maternity rooms, thus ordering the exhaustive cleaning of these rooms.
Subsequently, Phillipe Ignace Semmelweis, noted that the death rate from puerperal fever was directly proportional to the number of interventions where the doctor did not wash their hands previously and ordered the installation of sinks at the entrances of the operating rooms for all medical personnel.
In 1857, Pasteur showed by studying fermentation, that the presence of bacteria and microorganisms, and their reproduction in number, produced putrefaction.
Pasteur also discovered that heat killed these microorganisms, and that you only had to prevent new microorganisms from entering after eliminating them to avoid putrefaction. In 1867, Joseph Lister published a work proposing to clean wounds with carbolic acid.
Principles of asepsis
Aseptic principles are most commonly used in operating rooms, delivery rooms or when performing a procedure in the hospitalization bed that requires the greatest possible sterility, such as placing a chest tube, taking a central line, placing of a urethral catheter, among others.
In medicine, sterilization techniques and methods are used whenever a procedure requires the loss of the integrity of the skin, forming a gateway for microorganisms to enter the body.
The practice of asepsis, especially in surgery, requires the preoperative sterilization of the operating room and all the surgical equipment and instruments to be used, to avoid intraoperative infections and the consequent protection of the wound until its definitive resolution.
To achieve this, the aseptic principles listed below must be met:
1-All objects that are in a sterile area must be sterile. To do this, it must be verified that it is properly sealed and that its sterility expiration date is in order.
2-Every sterile object becomes a non-sterile object when it is touched by a non-sterile object.
3-Any sterile object whose location is below the level of the waist, is considered a non-sterile object.
4-Any sterile object or sterile field out of sight, is considered non-sterile.
5-All sterile objects can become non-sterile if they are exposed for a long time in a sterile field, as they are exposed to aerial microorganisms.
6-If there is any perforation, tear or humidity in a sterile barrier, it can no longer be considered sterile.
7-After placing a sterile drape, at least 1 inch along the entire edge is considered non-sterile.
8-If there is any doubt about the sterility of an object, then it is considered non-sterile.
9-People you consider sterile and objects considered sterile should only pass with the sterile environment. Those people considered non-sterile and objects considered non-sterile can only pass through the non-sterile environment.
10-The skin cannot be totally sterilized, so it is considered non-sterile.
11-Take care not to compromise the sterility of the sterile field, do not reach for objects leaning over the field, keep non-sterile objects away from the field, and take care not to sneeze, cough or speak on top of the sterile field.
Just as these principles help to maintain sterility in surgical medical procedures of any type, there are specific methods that help to maintain sterility in the performance of almost any procedure in medicine, from hand washing, to putting on gloves, the correct clothing, among others.
References
- Kennedy, 2013; Infection Control Today, 2000; ORNAC, 2011; Perry et al., 2014; Rothrock, 2014. Recovered from: opentextbc.ca
- Thomas Schlich. National Library of Medicine National Institutes of Health. Med Hist. 2012 Jul; 56 (3): 308–334. Published online 2012 Jul. Asepsis and Bacteriology: A Realignment of Surgery and Laboratory Science. Recovered from: ncbi.nlm.nih.gov
- Alfredio Jacome Roca. National Academy of Medicine. Asepsis and antisepsis. Recovered from: encolombia.com
- Francisco Cañestro Márquez, et al. TCAE in the sterilization service. Editorial Vertica. Malaga, Spain. 2007. Page 3 - 4.
- Surgical Asepsis. Recovered from: es.wikipedia.org